From the Department of Plastic and Reconstructive Surgery, The Johns Hopkins School of Medicine, Baltimore, MD.
Ann Plast Surg. 2022 Aug 1;89(2):152-158. doi: 10.1097/SAP.0000000000003101. Epub 2022 Feb 21.
Resident aesthetic clinics (RACs) provide plastic surgery residents with hands-on aesthetic surgery training. Although RACs have demonstrated successful surgical outcomes without compromising patient care, few studies have evaluated the efficacy or educational value of RACs to increase resident confidence and competence in procedures. In addition, clinic structures vary widely among institutions, with each clinic offering a unique patient volume, caseload, and degree of resident autonomy that impacts the clinic's educational value. This systematic review identifies existing RAC practices, compares clinic structures, and proposes a curriculum framework to maximize educational value for residents.
Following PRISMA guidelines, we performed a systematic review of plastic surgery residency training program RACs. We queried PubMed, Embase, and Web of Science from January 2000 to April 2020. Eligible articles were original articles that discussed RAC structure and educational value. Data abstracted included details on clinic structure (eg, volume, location, cost, clinic operations) and trainee-perceived educational value (eg, resident satisfaction, resident confidence in procedures).
Of 1199 identified publications, 10 met the inclusion criteria: 6 single-site studies and 4 national survey studies. Among the single-site studies, annual volumes ranged from 22 to 68 patients/year and 35 to 81 cases/year. Resident aesthetic clinics were all staffed by full-time academic faculty (100%); one-third also were staffed by adjunct faculty and 17% also by community plastic surgeons. Resident involvement varied by hours in clinic and degree of autonomy. The survey studies found that RACs increase resident confidence and competence in performing aesthetic procedures and identified critical challenges to RAC implementation (eg, financial viability, continuity of care) that limited RAC educational value. Based on this review's findings, we propose a 6-step RAC curriculum framework for training programs seeking to establish an RAC and maximize the clinic's educational value.
Resident aesthetic clinics are increasingly important for providing plastic surgery residents with aesthetic training. Patient and case volume, degree of resident autonomy, and clinic attending physicians are critical determinants of the educational value of RACs. We hope our findings can aid plastic surgery training programs in better organizing educational and sustainable RACs.
住院医师美容诊所（RAC）为整形外科住院医师提供实践美容手术培训。尽管 RAC 已证明在不影响患者护理的情况下获得了成功的手术效果，但很少有研究评估 RAC 增加住院医师对手术的信心和能力的效果或教育价值。此外，诊所结构在机构之间差异很大，每个诊所提供的患者数量、病例量和住院医师自主权的程度都不同，这会影响诊所的教育价值。本系统评价确定了现有的 RAC 实践，比较了诊所结构，并提出了一个课程框架，以最大限度地提高住院医师的教育价值。
根据 PRISMA 指南，我们对整形外科住院医师培训计划 RAC 进行了系统评价。我们在 2000 年 1 月至 2020 年 4 月期间在 PubMed、Embase 和 Web of Science 上进行了检索。符合纳入标准的文章为讨论 RAC 结构和教育价值的原始文章。提取的数据包括诊所结构的详细信息（例如，数量、地点、成本、诊所运营）和学员感知的教育价值（例如，住院医师满意度、住院医师对手术的信心）。
在 1199 篇已识别的出版物中，有 10 篇符合纳入标准：6 篇单站点研究和 4 篇全国调查研究。在单站点研究中，每年的患者数量范围为 22 至 68 例/年和 35 至 81 例/年。住院医师美容诊所均由全职学术教员（100%）配备人员；三分之一的诊所还配备了兼职教员，17%的诊所还配备了社区整形外科医生。住院医师的参与程度因诊所的工作时间和自主权的程度而异。调查研究发现，RAC 增加了住院医师对执行美容手术的信心和能力，并确定了 RAC 实施所面临的关键挑战（例如，财务可行性、护理连续性），这些挑战限制了 RAC 的教育价值。基于本综述的结果，我们提出了一个 6 步 RAC 课程框架，供寻求建立 RAC 并最大限度地提高诊所教育价值的培训计划使用。
住院医师美容诊所对于为整形外科住院医师提供美容培训越来越重要。患者和病例数量、住院医师自主权的程度以及诊所主治医生是 RAC 教育价值的关键决定因素。我们希望我们的发现可以帮助整形外科培训计划更好地组织教育和可持续的 RAC。
